Provider Demographics
NPI:1235496886
Name:MUSINGA, EMMANUEL
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:
Last Name:MUSINGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 ORCHARD LN APT 218
Mailing Address - Street 2:
Mailing Address - City:CARBON CLIFF
Mailing Address - State:IL
Mailing Address - Zip Code:61239-8812
Mailing Address - Country:US
Mailing Address - Phone:309-716-6931
Mailing Address - Fax:
Practice Address - Street 1:3202 ORCHARD LN APT 218
Practice Address - Street 2:
Practice Address - City:CARBON CLIFF
Practice Address - State:IL
Practice Address - Zip Code:61239-8812
Practice Address - Country:US
Practice Address - Phone:309-716-6931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter